Stability factors after double-jaw surgery in Class III malocclusion. A systematic review.
OBJECTIVE
To identify the stability factors of skeletal Class III malocclusion after double-jaw surgery by a systematic review of the literature.


METHODS
The survey covered the period from September 1959 to October 2007 and used the MeSH, Medical Subject Headings. The inclusion criteria were stability of bimaxillary surgery of the permanent dentition, adult patients with skeletal Class III malocclusion, a follow-up of at least 12 months, randomized and nonrandomized controlled clinical trials (RCCTs; CCTs), prospective and retrospective studies with and without concurrent untreated as well as normal controls, and clinical trials (CTs) comparing at least two treatment strategies without any untreated or normal control group.


RESULTS
The search strategy resulted in 1783 articles. After selection according to the inclusion/ exclusion criteria, 15 articles qualified for the final review analysis. Quality was low in two studies, medium in twelve, and medium/high in one article, which was represented by a RCT (randomized clinical trial). Most of the studies had sufficient sample size, method error analysis, and adequate statistical methods. Thus, the quality level of the studies was sufficient to draw evidence-based conclusions.


CONCLUSIONS
Surgical correction of skeletal Class III malocclusion after combined maxillary and mandibular procedures appears to be stable for maxillary advancements up to 5 mm and for the correction of presurgical sagittal intermaxillary discrepancies smaller than 7 mm.
Mucedero
Manuela
M
Department of Orthodontics, University of Rome Tor Vergata, Rome, Italy.
Coviello
Antonella
A
Baccetti
Tiziano
T
Franchi
Lorenzo
L
Cozza
Paola
P
D000328:Adult; D002986:Clinical Trials as Topic; D005500:Follow-Up Studies; D006801:Humans; D008313:Malocclusion, Angle Class III / Q000601:surgery*; D008334:Mandible / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012189:Retrospective Studies